Completed Initiatives

State Innovation Model (SIM) Consumer Engagement

The Commonwealth Institute of Kentucky (CIK) was contracted by the Cabinet for Health and Family Services to assess Kentuckians’ current health-related needs and to make recommendations for engaging consumers and their advocates in Kentucky’s State Innovation Model (SIM) initiative. Kentucky’s SIM process was funded through a $2 million model design award from the Centers for Medicare and Medicaid Services (CMS), and focused on addressing population health improvement through planning new payment and service delivery models.

To that end, the CIK team collected and analyzed feedback from Kentuckians regarding their experiences as health care consumers in terms of cost, access, and quality. Key findings of the study  are in line with national surveys and existing literature, and  point to improved access to care with the implementation of Medicaid expansion and kynect. Consumers expressed satisfaction  in regards to their ability to utilize services that were not available before because of cost reductions since insurance coverage has increased in Kentucky. 

At the same time, the study revealed consumer concerns and frustration in terms of communication and amount of time spent with providers and an overall confusion about navigating the health care system. Additional concerns included occasional difficulty finding providers that accept certain insurance plans and a lack of availability of behavioral and oral health care providers.

Findings of this study were integrated into Kentucky’s State Health System Innovation Plan. For more information about this evaluation project, please contact Dr. Susan Buchino at susan.buchino@louisville.edu.

LGBTQ Health Equity and Access

Following implementation of the Patient Protection and Affordable Care Act (ACA), Kentucky Voices for Health (KVH) sought to discover the experiences of Kentucky’s lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities when signing up for health insurance and using health care.  KVH asked  researchers from the Commonwealth Institute of Kentucky to conduct a qualitative study with LGBTQ communities from across the state from October to December 2015.

The research found that LGBT people experienced issues such as low health insurance literacy, difficulty navigating bureaucracy, frustrations with technology, and concerns about cost.  Unique difficulties, however, included systemic barriers such as transgender health exclusions in insurance policies and billing errors due to gender marker mismatches.  Participants in the study also discussed poor treatment by office staff and health care providers, which eroded their trust in the health care system.

Specific recommendations of this study included increasing the cultural competency and inclusivity of health services, enhancing policies and regulations that support access to care of LGBTQ populations, and creating specific resources for advocacy and meeting the unique needs of LGBTQ populations.  For more information about this study, please contact Dr. Ryan Combs at  or view the project report.

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